Making menopause easier

As the world marks World Menopause Day on 18 October, millions of Indian women over 45 are
finding it difficult to smile through it - thanks to the lack of information and misunderstanding
among them about this rather rough phase of life.
Neeta Lal
reports on the Delhi-based Indian Menopause Society.

, New Delhi, (WFS) - "It's a sign of the times when your roots are grey and your mem'ry's shorter; It's a sign of the times when your hourglass shape becomes a glass of water." (Menopause, The Musical, 2001)

Writer Jeanie Linders, of the famous Menopause, The Musical may have sung her
way through menopause and won accolades for it. However, as the world marks World Menopause Day on October 18, millions of Indian women over 45 are
finding it difficult to smile through it - thanks to the lack of information and
misunderstanding among them about this rather rough phase of life.

Menopausal women have to deal with hot flushes (periods of sweating and rapid
heartbeats), irritability and heightened levels of stress on a daily basis. In
the long run, they become susceptible to cardiovascular diseases, osteoporosis
and cancer due to falling levels of oestrogen and progesterone hormones. These
hormones help maintain healthy bones and protect the heart and veins by
increasing levels of 'good cholesterol' (HDL or High Density Lipoprotein) and
lowering 'bad cholesterol' (LDL or Low Density Lipoprotein).

Understanding menopause

Menopause is accompanied by physical changes like the termination of periods and the capacity to bear children.

The body decreases production of oestrogen and progesterone - which are required primarily for reproductive functions - affecting a woman's overall health and leaving her vulnerable to ailments like osteoporosis.

Plummeting levels of oestrogen trigger off increased blood flow to the face, neck, chest and back, resulting in hot flushes.

Mood swings and decreased sex drive are caused by a decrease in hormone levels, hot flushes and vaginal dryness.

In 1995, about 450 doctors - cardiologists, nutritionists, gynaecologists,
orthopaedics, ultrasonologists - pooled their collective professional expertise
to form the Indian Menopause Society (IMS). Based in New Delhi with affiliated
clinics all over India, IMS is a pan-India platform that seeks to address
menopause-related health issues and educate women about this crucial stage in
their lives.

According to IMS research, there are currently 65 million Indian women over the
age of 45. Not only that, according to IMS, menopause often strikes Indian women
as young as 30-35 years. Despite these figures, IMS founders discovered at its
inception that - like most Indian women (including the urban elite) - doctors
and health professionals themselves were quite clueless about menopause-related
issues.

"Menopause is the most misunderstood biological change that happens to a woman,"
says Delhi-based Dr Sonia Malik, IMS President-elect. An infertility and
in-vitro fertilisation expert, Dr Malik comments that the changes can be
traumatic and psychologically challenging for women. "Organisations like ours
can play a pivotal role in creating awareness about it, not only amongst medical
professionals but also among lay persons."

Through its 15 chapters in various Indian states, IMS provides a common forum
for health professionals and the general public to work towards the wellbeing of
menopausal women. Members raise awareness about menopause and ageing through
outreach programmes and public health and education campaigns. They also hold
charitable screening camps and workshops offering heavily discounted or free
tests like pap smears, mammograms and ultrasounds. The outfit also distributes
pamphlets, flyers and booklets to women across various economic strata to
educate them about menopause.

"The idea is to promote a multi-disciplinary and comprehensive approach for the
care of elderly women - both medical and non-medical. We also regularly update
doctors and health professionals in the field of menopausal medicine to ensure
appropriate health care for this age group," says Hyderabad-based Dr Meeta
Singh, IMS secretary-general.

IMS's National Data Collection programme collects information and promotes
research on menopause, with special relevance to Indian women. The organisation
also offers a range of voluntary services like counselling families and
underprivileged women in menopause clinics affiliated to IMS. Both doctors and
people from non-medical backgrounds can volunteer at these clinics.

The aim, as Singh puts it, is to work towards women's empowerment through
menopausal health. "Even though awareness about menopause is growing, most
Indian women have a history of self-denial and neglect. Their family's needs
take precedence over their own. So we created a public awareness teaching module
for our members to reach out to older women."

Apart from a 30-minute PowerPoint presentation on menopausal health followed by
an interactive session and a quiz, the public awareness teaching module consists
of a National Awareness Programme - 'Fit at 40, Strong at 60'. The module was
presented in 30 Indian cities and it also distributed feedback forms to gauge
Indian women's perception of menopause. The responses revealed that most women
are not very well informed about menopause, and myths such as menopause being a
'disease' rather than a natural phenomenon were readily believed. It was found
that even educated women believed that ill-health was a part of menopause.

Apart from efforts at the national level, most IMS-affiliated doctors have a
local team (comprising a voluntary medical counsellor, a nutritionist and two
volunteers) at their clinics to counsel menopausal women about their health,
osteoporosis and nutrition. Easy exercises that develop strength, flexibility
and balance are also taught at the clinics. "We strongly endorse the mantra,
'Use it or Lose it' - be it the brain, bone or muscle," says Singh.

IMS has also formed local menopause and osteoporosis clubs that meet quarterly
to help women exchange views on menopause, interact with experts in the field
and explore their non-medical needs like stress and depression. These meetings
help women to further de-stress.

Recently, IMS also launched a novel outreach programme for menopausal caregivers
of Alzheimer's patients. "We discovered that these caregivers were so depressed
themselves that it was seriously affecting their health and hence the quality of
their care too," explains Malik. "So we created a venue where they could
de-stress by talking about their problems and their patients, and also get
counselling on menopause from various experts in the field." IMS plans similar
outreach programmes for menopausal women battling with their relatives'
alcoholism and cancer.

However, despite its commendable work, IMS finds itself short on funds. Its
current projects are either self-funded or financed through a network of
sympathetic organisations. "India is yet to fully acknowledge the true impact of
menopause on women, their lives and their productivity. When women reach this
stage in their lives, they are at the peak of their productivity as workers and
individuals. This is why IMS is trying to create a robust, national forum that
can address the psychological, biological and emotional needs of menopausal
women," says Malik. (Women's Feature Service)

Neeta Lal18 October 2006

Neeta Lal is a freelance writer based in Delhi. The Indian Menopause Society is online at www.indianmenopausesociety.org.

Rashmi Gangwar
Many thanks for the useful information. Can we have the list of IMS's 15 chapters and the address of UP Chapter. Would it also be possible to have a copy of the 30-minute PowerPoint presentation on menopausal health and the public awareness teaching module for - 'Fit at 40, Strong at 60'.

December 04 2006, 7:26 AM ·
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poonam awasthi
Thanks a lot for this effort. If possible please let me know, is there any direct relation between hypertension and menopause? Does blood pressure suddenly shoots up during menopause?

March 09 2007, 5:24 PM ·
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